NPIMap

Organization Active NPI

Freedom Home Dialysis, LLC

Doing business as Freedom Home Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Frederick, MD
National Provider Identifier
1104102839
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
E2661 Issued in MD
Legal business name
FREEDOM HOME DIALYSIS, LLC
Doing business as
Freedom Home Dialysis
Practice address
45 Thomas Johnson Dr
Suite 211
Frederick, MD 21702-4425
Phone
(301) 624-1054
Fax
(301) 663-9571
NPI assigned
Oct 26, 2011
Last updated
Oct 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Branislav S Romanic, MDNPI 1649239153
Title
Owner and Medical Director
Phone
(301) 663-9570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X E2661 MD Primary

Addresses

Primary practice location

45 Thomas Johnson Dr
Suite 211
Frederick, MD 21702-4425

Mailing address

45 Thomas Johnson Dr
Suite 211
Frederick, MD 21702-4425
Phone (301) 624-1054

Other identifiers 1

IdentifierTypeStateIssuer
419939100MedicaidMD

Other names 1

  • FREEDOM HOME DIALYSIS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1104102839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 THOMAS JOHNSON DR",
            "address_2": "SUITE 211",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024425",
            "telephone_number": "301-624-1054",
            "fax_number": "301-663-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 THOMAS JOHNSON DR",
            "address_2": "SUITE 211",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024425",
            "telephone_number": "301-624-1054",
            "fax_number": "301-663-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM HOME DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "ROMANIC",
        "authorized_official_first_name": "BRANISLAV",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-663-9570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": "E2661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419939100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREEDOM HOME DIALYSIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.